Provider Information for 1982066866
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SANDRA WEST
Sex: Female
NPI: 1982066866
Last Updated: 2019-07-22
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1982066866 | ||||||||
| Enumeration Date | 2016-03-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 1170 NORTH FORK, CA 93643-1170 United States Phone: 559-246-2132 | Fax: | ||||||||
| Primary Practice Address | 4411 E KINGS CANYON RD FRESNO, CA 93702-3604 United States Phone: 559-246-2132 | Fax: | ||||||||
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